WASHINGTON — The Department of Veterans Affairs has for years touted the achievements of its health care system, but a new study shows that its health outcomes are just about like everybody else's.

The VA highlighted the study, published in the journal Medical Care, saying in a news release this week that "VA Health System Shines in Quality-of-Care Study."

"This report is strong evidence of the advancements VA continues to make in improving health care over the past 15 years," VA Secretary Eric Shinseki said in the release. "The systems and quality-improvement measures VA actively uses are second to none, and the results speak for themselves."

However, the study, which synthesized the results of three dozen other studies that compared VA health care with care provided by non-VA providers, concluded that the VA performed well on many measures of medical care, but also found that the VA had little impact on the key question of whether patients lived or died.

Moreover, most of the research the study depended on to reach its conclusions dates to when Bill Clinton was president. One source for the study is dated 1991, when George H.W. Bush was in the White House.

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The issue of how good is VA care is a hot topic among veterans' advocates and Congress. Some recent studies have been used to make the case that VA care is not only pretty good, it's also among the best in the country. That's a big turnaround from two decades ago, when the VA was widely derided for poor quality. Since then, the agency has transformed from a hospital-based system to an integrated network of hospitals and clinics that is commended for its emphasis on preventive care.

But the best care anywhere? What the latest study shows is that the VA performs well on what are known as "process" measures — whether a certain test was ordered, for example. But studies that compare health outcomes — do patients in the VA system do better or live longer? — are equivocal.

Of 12 studies that compared mortality, for example, three showed a better outcome for VA patients, two showed a better outcome for non-VA patients, and seven showed no difference. That's very different from the process measures, which showed an overwhelming VA advantage.

Researchers aren't sure what causes that disconnect. If veterans are taking their drugs and getting their tests done, the thinking goes, they should be living longer. But for the most part, the data don't show that.

"When it comes to mortality, we found that the VA does no better and does no worse," said study author Amal Trivedi, an investigator at a VA medical center in Providence, R.I.

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